Why incorporating benazepril into a renal diet may improve treatment efficiency and compliance in cats with chronic kidney disease

Treating cats with chronic kidney disease generally requires daily administration of an antiproteinuric drug, which can impact medication compliance with medical outcomes as well as negative implications for the wellbeing of the cat and the owner. In addition, for a given daily dose, benazepril is more effective when administered several times a day but this could increase non compliance. It was therefore conceived to incorporate benazepril into a highly palatable diet for cats with chronic kidney disease, that is, a medicated diet, that the cats could consume throughout the day, with the aim of replacing multiple administrations thanks to the cat's nibbler eating behavior and the slow gastric emptying in cats eating dry food. Our investigation showed that Consumption of the medicated diet led to an overall lower drug exposure in both healthy and CKD cats compared to benazepril once-daily tablets. Nevertheless, the overall efficacy in inhibiting ACE was at least equivalent (CKD cats) and even higher (healthy cats). In both cases, this resulted in greater efficiency (i.e., the amount of desired therapeutic effect produced per unit of drug exposure) of the medicated diet than of conventional once daily tablet administration. More broadly, this observation suggests that the temporal pattern of benazepril exposure may be more important than the total dose administered. Medicated diets may represent a new strategy for improving both compliance and therapeutic efficiency in chronic feline diseases, provided that the diet is well accepted by the cat.